Would expect that we would need to target a daily dose of ~5500mg
(~1800g IV Q8H)

Although we want to ideally target 15-20mg/L, the benefits of ~doubling the dose to target 15-20mg/L likely won’t outweigh the risks (e.g. risk of accumulation
→ increased risk of nephrotoxicity and ototoxicity) when the patient is already improving at a significantly sub-therapeutic level.

Keeping in mind: patient improving at sub-therapeutic level may indicate that patient is improving on other antibiotic therapy and that coverage against MRSA may not be warranted. Pharmacy should follow up with MRSA screen.